economy

[Script]

Matthias,

you agree that anarchism wouldn't work on a large scale as in the US or the entire west. Then you call for having discussions about these concepts so that people actually know what they could be voting for instead.

That works for intellectuals like us, but it doesn't for at least 40% of US citizens (any more). Also, we simply cannot expect the mom with four kids and others to sit down, read and digest Marx, Anarchism, Anti-Capitalism etc etc. Teach all that at school? You don't need to convince me. Yes, you can't easily make someone on the economic fringe jump with self-confidence into something they can't grasp. I have met people, believe it or not, who when they hear anarchism immediately think of looting mobs, and I know others who prefer to spend all their money (and actually more) because they think that anti-capitalism is the hype of the day. Yes, sometimes it's very simple. So you want to educate them all to 'mature' level? How long does that take? I think, instead, we need more good interpreters. And I don't mean types like J-J Rouseeau.

I'm calling for oxymorons? Am I? I don't think so, but reality certainly is. Look, actually look -- don't try to intellectually analyze and explain(!) -- the Brexit campaigning success and the latest Trumpism. Look at the successes of right-leaning parties all across Europe. Much of it is so entirely void of intellectual thought as we know it and instead full of sentiment and resentments, and it's scary to see for what reasons some people opt for that.

Again, we need more interpreters who spread much easier-to-understand but poignant ideas and concrete/practicable solutions -- and I'd add solutions that are applicable to the current system in order to slowly change it. Hopefully, by sewing more simple but realistic ideas we will at the end have something much closer to anarchism (or whatever) one day than we can possibly image today, but it will most certainly not be called that.

---
OK, it's getting late my end and the exploitative capitalist world is calling me for duty tomorrow.

 

[mattiasNYC]

Matthias,

you agree that anarchism wouldn't work on a large scale as in the US or the entire west.

No, I don't agree with that.

Then you call for having discussions about these concepts so that people actually know what they could be voting for instead.

That works for intellectuals like us, but it doesn't for at least 40% of US citizens (any more).

Then the question is if you can encourage intellectualism to the point of it working for a sufficient amount of people, and if you cannot just how you determine which subset of people govern the rest, because that's really the alternative.

Also, we simply cannot expect the mom with four kids and others to sit down, read and digest Marx, Anarchism, Anti-Capitalism etc etc. Teach all that at school? You don't need to convince me. Yes, you can't easily make someone on the economic fringe jump with self-confidence into something they can't grasp. I have met people, believe it or not, who when they hear anarchism immediately think of looting mobs, and I know others who prefer to spend all their money (and actually more) because they think that anti-capitalism is the hype of the day. Yes, sometimes it's very simple. So you want to educate them all to 'mature' level? How long does that take? I think, instead, we need more good interpreters. And I don't mean types like J-J Rouseeau.

I'm calling for oxymorons? Am I? I don't think so, but reality certainly is. Look, actually look -- don't try to intellectually analyze and explain(!) -- the Brexit campaigning success and the latest Trumpism. Look at the successes of right-leaning parties all across Europe. Much of it is so entirely void of intellectual thought as we know it and instead full of sentiment and resentments, and it's scary to see for what reasons some people opt for that.

Again, we need more interpreters who spread much easier-to-understand but poignant ideas and concrete/practicable solutions -- and I'd add solutions that are applicable to the current system in order to slowly change it. Hopefully, by sewing more simple but realistic ideas we will at the end have something much closer to anarchism (or whatever) one day than we can possibly image today, but it will most certainly not be called that.

---
OK, it's getting late my end and the exploitative capitalist world is calling me for duty tomorrow.

I don't disagree with your view on how difficult it is to change people's minds and give them needed information, not at all. I just don't really see much evidence that we'll slowly move to a better place. I know I'm being pessimistic, but I think it has to get a lot worse - a lot - before it gets better. And at that point I don't think change will be 'slow' necessarily.

I will say this though: There may very well be places in "the west" where change can happen slowly. I would imagine that to be predominantly in nations that conceptually embrace what Sweden embraced decades ago. That could mean anything from older solutions that were proven to work, to newer solutions which never were tried or were simply technically impossible to execute. For those nations we might see some type of change. I'm thinking of smaller nations like Belgium (though it'd eventually have to disconnect from the rest of Europe), Switzerland or even a nation like Uruguay.

In a sense even chaotic nations that are on the verge of collapse, or ones that do collapse, might be better suited to build something better simply because their "baggage" all "burned up" anyway.

 

[dmp]

rule of law and the right to own property is the engine for economic growth. Government capture of private wealth (presumably to redistribute after they get a taste) typically just dissipates that wealth over time making more people poor.It is using the wrong question to gin up consensus.
...

Small business IMO is much preferable to big business... Big business can also afford lobby legislators and win even more advantages over small competitors AKA crony capitalism. Big government or big business is not beautiful IMO.

JR

I agree that small business is preferable & I think that the government structure should facilitate it. At the moment it is tipping the other way. I am not arguing for Government ownership of capital, but a system that creates a healthy economy, opportunity, and fairness so worker's benefit appropriately from their labor.
The Government is currently capturing ~14% of GDP. The way it does that is important. Things like the mortgage interest deduction, health ins deduction within business (not individually), lower capital gains rate than the rate for labor income, etc...
Unless the Government adopts fairer progressive tax schemes & well thought out regulation, average workers and small businesses won't be able to compete with big business.
I like co-operative business models and would like to see them empowered to be more competitive.  Under the current system it is hard to compete unless you follow all the dirty tricks of big business.
A really interesting anecdote I saw was that health insurance companies liked the ACA because they didn't like denying sick people insurance. But they had to do so to compete in the market. A level playing field with regulations on preexisting conditions was appreciated by them.  They didn't want to be evil.

 

[benb]

I'll leave it to you guys to work out the labels for what to call each other. The real economic challenge is not globalization and cheap labor, but automation and ever cheaper robotics. I have been posting for years how Hon Hai a huge contract manufacturer in China has projected to buy/build 1 million robots to use in their chinese factories.

In the US the first shoe to drop will be truck drivers, but even white collar jobs are being replaced by AI.

The "first shoe" may be fast food workers, as in Momentum Machines (fast-food robotic cooking equipment company targeting/working with McDonalds) described in "Rise Of The Robots," and this story  of Wendy's getting ordering kiosks in 1,000 restaurants (I've heard some McDonalds also have ordering kiosks instead of cashiers). Unlike self-driving vehicles, these machines don't need (much) government approval, and they're unlikely to hurt or kill anyone if something goes wrong:
http://www.csmonitor.com/Business/2017/0227/Coming-to-a-Wendy-s-near-you-Self-ordering-kiosks

An interesting education trend is how short term coding schools in 3 months for $10-15k can get a reasonably intelligent worker into the door with a decent paying entry level programming job.

Interesting times to come...sooner rather than later.

JR

Speaking of interesting times allegedly to come, I was listening to this video, but eventually just went through the slides at the PDF on this page. It's of course a lot about "far out" (in several meanings of the phrase) stuff, including economics. It discusses how humans currently have high value,  but that this may change (to humans not worth much, if anything) presuming automation and robotics increase as much as as some predict:
http://2012.singularitysummit.com.au/2012/08/can-intelligence-explode/

 

[tands]

A really interesting anecdote I saw was that health insurance companies liked the ACA because they didn't like denying sick people insurance. But they had to do so to compete in the market. A level playing field with regulations on preexisting conditions was appreciated by them.  They didn't want to be evil.

They like Obamacare because it forces people to buy their product, assuring their profit.

Ignore what they say, base your analysis on what they do. Health insurance is an evil industry, they make more profit by denying care, and they have a legal obligation to their shareholders (John?) to make as much profit as they can. They're evil through and through, and they're well aware of it.

 

[JohnRoberts]

The "first shoe" may be fast food workers, as in Momentum Machines (fast-food robotic cooking equipment company targeting/working with McDonalds) described in "Rise Of The Robots," and this story  of Wendy's getting ordering kiosks in 1,000 restaurants (I've heard some McDonalds also have ordering kiosks instead of cashiers). Unlike self-driving vehicles, these machines don't need (much) government approval, and they're unlikely to hurt or kill anyone if something goes wrong:
http://www.csmonitor.com/Business/2017/0227/Coming-to-a-Wendy-s-near-you-Self-ordering-kiosks

This shift is being accelerated by increasing minimum wage rates beyond the point of human workers being profitable in fast food service industry. All that government help, is helping the robotics sellers more than workers.

Entry level jobs are not supposed to support head of household workers, but be the first rung on the employment ladder to teach kids how to work (show up every day, dress clean, don't talk smack to the boss, etc).  Pricing these minimum wage jobs too high will price inexperienced kids out of the job market, with negative consequences for their future.

JR

Speaking of interesting times allegedly to come, I was listening to this video, but eventually just went through the slides at the PDF on this page. It's of course a lot about "far out" (in several meanings of the phrase) stuff, including economics. It discusses how humans currently have high value,  but that this may change (to humans not worth much, if anything) presuming automation and robotics increase as much as as some predict:
http://2012.singularitysummit.com.au/2012/08/can-intelligence-explode/

 

[dmp]

They like Obamacare because it forces people to buy their product, assuring their profit. Ignore what they say, base your analysis on what they do. Health insurance is an evil industry, they make more profit by denying care, and they have a legal obligation to their shareholders (John?) to make as much profit as they can. They're evil through and through, and they're well aware of it.

I agree that a lot of health insurance companies make a profit that increases costs for everyone and greed does make evil - especially when it involves denying health care to your customer through the fine print in a contract.

But it doesn't have to be that way - I have had health insurance I really like for over a decade with a Co-operative (Group Health) that is a non-profit.  It is more expensive than the competition (blue cross etc) but you get what you pay for. Maybe people need to stop giving the evil corporations business?

But the real elephant in the room is that health services are extremely expensive. I read that the sickest 5% of people incur cost 50% of costs and the sickest 10% of people incur 90% of costs.  Reduced costs are needed but the new  Rinocare plan doesn't seem to do that. It cuts the taxes that funded the ACA completely and it removes the mandate so the healthy (cheap) people will leave the system. Accelerate the death spiral and borrow the money on the way.

 

[tands]

It's not like you won't be that sick one day, just like the rest of us, dmp. Single payer/Medicare for all is the future, Obamacare was just an effort to stave off that day to keep the industry profiting.

(1) “Free” markets do not occur naturally. They must be actively constructed through political organizing.

(4) The political goal of neoliberals is not to destroy the state, but to take control of it, and to redefine its structure and function, in order to create and maintain the market-friendly culture.

Trumpcare seems to be so universally disliked that it'll never pass, which may have been the idea..

 

[JohnRoberts]

They like Obamacare because it forces people to buy their product, assuring their profit.

Ignore what they say, base your analysis on what they do. Health insurance is an evil industry, they make more profit by denying care, and they have a legal obligation to their shareholders (John?) to make as much profit as they can. They're evil through and through, and they're well aware of it.

moi?

I have written about insurance before and pure insurance is not evil. It serves a valuable function for business and individuals...(I buy insurance for my car, and house to protect me from catastrophic losses. Not to pay for oil changes or yard service. )

What we call health insurance is distorted and far from simple insurance.  I am hopeful that the congress will come up with some reforms to increase competition and choices, while lowering cost, but the reality is we are more than a little pregnant with this new entitlement, and once the US public gets used to receiving "free sh__" you can never get them off the government teat. 

The ACA was unsustainable as written,  and it is odd to see the republicans engaged with reforming such a massive new entitlement.  As I posted months ago, this will not be easy (actually said that years ago) and it will take longer than people think to fully reform. There are huge philosophical differences within the republican party. Many Trump voters actually thought they could just flush this law and move on, but no. There are some 10-20 million people that will always require assistance, and the rest of us will have to pay for them (one way or the other..) . It's  more effective to recognize it and deal with it head on.  More importantly we need to not trash the health care services for the other 300 million people just to support the 10-20 million needy.

JR

PS: I have written about this for years (before you joined us),,, last time i checked Germany had a mostly private healthcare industry but the government provided low income individuals with financial support so they could afford to participate in private health care. I have not reviewed this situation since Merkel invited a million (?) migrants to come live in Germany. The concept was probably for them to supplant the workforce, but I suspect some fraction are a new drain on the German economy. (Maybe a German forum member can update us?).

 

[dmp]

It's not like you won't be that sick one day, just like the rest of us, dmp. Single payer/Medicare for all is the future, Obamacare was just an effort to stave off that day to keep the industry profiting.

Huh?

However you decided to do it, you need the costs to be affordable. You can't just put on your tin foil hat, wave a magic wand, and have single payer health care work beautifully.  Either individuals write a check to their health insurance company or to the IRS - it still needs to be paid for.  Deficit spending is unsustainable.
My point was NOT that sick people are the problem or that care needs to be rationed - rather the efficiency and cost effectiveness of the health care system needs to be improved. Maybe Doctors don't need to be making $200k to $500k as a starting salary. Maybe reducing visits to the emergency room for routine care. Etc. etc.  Reduce administrative load. This is an area JohnR has talked about  - creating a more efficient market.  If your car insurance covered oil changes would people shop around for a good deal on the service?

 

[tands]

Don't worry so much, it'll be fine.  Many countries have it already. Canadia for instance, just across the border - the promised land.

The goal of this demographic slicing and dicing is to identify physicians who are most susceptible to marketing efforts. One industry article suggests categorizing physicians as “hidden gems”: “Initially considered ‘low value’ because they are low prescribers, these physicians can change their prescribing habits after targeted, effective marketing.” “Growers” are “Physicians who are early adopters of a brand. Pharmaceutical companies employ retention strategies to continue to reinforce their growth behavior.” Physicians are considered “low value” “due to low category share and prescribing level” [9].

In an interview with Pharmaceutical Representative, Fred Marshall, president of Quantum Learning, explained, “… One type might be called ‘the spreader’ who uses a little bit of everybody's product. The second type might be a ‘loyalist’, who's very loyal to one particular product and uses it for most patient types. Another physician might be a ‘niche’ physician, who reserves our product only for a very narrowly defined patient type. And the idea in physician segmentation would be to have a different messaging strategy for each of those physician segments ” [10].

In Pharmaceutical Executive, Ron Brand of IMS Consulting writes “…integrated segmentation analyzes individual prescribing behaviors, demographics, and psychographics (attitudes, beliefs, and values) to fine-tune sales targets. For a particular product, for example, one segment might consist of price-sensitive physicians, another might include doctors loyal to a given manufacturers brand, and a third may include those unfriendly towards reps” [11].

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1876413/

 

[JohnRoberts]

Don't worry so much, it'll be fine.  Many countries have it already. Canadia for instance, just across the border - the promised land.

Most countries with socialized medicine are suffering from the same demographic trends (aging population supported by less young workers), and advances in medicine's ability to keep sick people alive incurring disproportionate expense for EOL (end of life) treatment.

Speaking of Canada, medical treatment for pets is not socialized there so you can get your dog or cat operated on almost immediately, while humans often have to wait in queues to get their turn. Canadians who can afford to, will sometimes pay to jump the line and get treated in the US, rather than wait.

I am not opposed to subsidizing the weakest among us, but anybody who thinks socialized medicine is simple or easy, has not been paying attention to the state of socialized medicine around the world. Some countries are doing better than others but they are all a little different.

We have very high expectations for what this should involve, but limited resources to pay for it, unless we can make it far more cost effective.

JR

 

[dmp]

About how to pay for health care: the ACA included some tax increases to make it work. The Republican plan ends those taxes.

To pay for its spending, Obamacare included several taxes on couples making more than $250,000, like a 3.8 percent surtax on investment income and a 0.9 percent surtax on wages.

https://www.theatlantic.com/business/archive/2017/03/acha-tax-cut/518889/

The reality is the ACA made the health care system in the US more socialized with tax increases on high incomes, which Republicans are aiming to roll back.  Because outright repealing the coverage of the 20 million or so people would have so much political blowback, it seems they are following a 'starve the beast' strategy to defund it first. And they are limited in what they can do in the reconciliation stage. 

Many countries have it already. Canadia for instance, just across the border - the promised land.

Good luck - I don't see it happening anytime soon. I wish the Democrats had added a public option to the ACA but I don't think they could get it past the big corporate lobbies. Basically let people buy into medicare as a group plan - in competition with private options. Instead of the whole health exchange stuff that didn't work.

 

[mattiasNYC]

  Either individuals write a check to their health insurance company or to the IRS - it still needs to be paid for.  Deficit spending is unsustainable.
My point was NOT that sick people are the problem or that care needs to be rationed - rather the efficiency and cost effectiveness of the health care system needs to be improved. Maybe Doctors don't need to be making $200k to $500k as a starting salary. Maybe reducing visits to the emergency room for routine care. Etc. etc.  Reduce administrative load. This is an area JohnR has talked about  - creating a more efficient market.  If your car insurance covered oil changes would people shop around for a good deal on the service?

But from the standpoint of the consumer anything that doesn't actually go to health care per se is waste, just like "deficit spending". So to the consumer it really shouldn't matter if they pay the government for service via the IRS or if they pay private insurers. There's going to be "waste" from the consumers standpoint in both cases; in the former because of what John no doubt would call inevitable inefficiencies when the government does anything (which isn't even close to being true of course) and in the latter it's simply called 'profit'.

So if one objection is that maybe doctors don't need to make that much money the answer is that you could actually change that by not leaving it in private hands.

 

[dmp]

So to the consumer it really shouldn't matter if they pay the government for service via the IRS or if they pay private insurers.

It makes a big difference if you are applying a progressive tax system to make the economics work.

So if one objection is that maybe doctors don't need to make that much money the answer is that you could actually change that by not leaving it in private hands.

I think this is very difficult. And I'm guessing this is something John would agree with. It is very difficult for the Government to mandate how much a doctor (or a teacher, etc) should make when providing a service to the public. Pay too little and there is no incentive for people to pursue the education for the field. A lack of merit based system for compensation leads to poor quality. I think competition is important.  Just have the gov pick up the tab and costs go through the roof.
The current system is just crony capitalism with obscene cost though so it would be hard to have it be much worse (other than for the very wealthy).

 

[mattiasNYC]

It makes a big difference if you are applying a progressive tax system to make the economics work.

Yeah, but now you're talking about taxation as a whole which then needs to be talked about as a whole, not just juxtaposed to health care. I'm pretty sure that a lot of people are ok with high taxes, it's just a matter of what they get for it and who's paying and how. Nobody cares if Bill Gates has to pay another 1% in taxes (or whatever), other than people who are Bill gates, are like Bill gates, or want and think they can be like Bill Gates.

I think this is very difficult. And I'm guessing this is something John would agree with. It is very difficult for the Government to mandate how much a doctor (or a teacher, etc) should make when providing a service to the public. Pay too little and there is no incentive for people to pursue the education for the field. A lack of merit based system for compensation leads to poor quality. I think competition is important.  Just have the gov pick up the tab and costs go through the roof.
The current system is just crony capitalism with obscene cost though so it would be hard to have it be much worse (other than for the very wealthy).

The system doesn't have to lack merit. Basically you're just arguing for one out of two different ways of going about imposing restrictions on profit: either you have the government straight up limit potential profit or tax it retroactively, the latter leaving open the possibility for very creative accounting which defeats the purpose, or you have the provide the service itself.

In the latter case you still can have a range of wages to those who choose the profession, thereby encouraging performance. As you said, we now have an "obscene cost", so I don't see why you would be so against the government doing it and are assuming costs would go through the roof if it did. We already tried capitalism and the US outspends a vast amount of nations without providing better or more care to a huge number of Americans.

Again, Scandinavia, especially in the 60's-80's.....

 

[dmp]

so I don't see why you would be so against the government doing it

I'm talking about the details of whether it can be done. I would support a single payer system if it worked economically and maintained good quality of care.
I said just above I was disappointed that the ACA didn't have a public option.
If the country voted out Democrats for the ACA and are about to see it reversed by Republicans, I don't see any hope for single payer.
If a political party (Dems, socialists) in the future did enact single payer there would be a lot of conservatives against it trying to make it fail. Look at Trumps appointments to all these agencies republicans hate, like the EPA. They defund and undermine until it fails. You can't see that happening to single payer health insurance even if it did get put in place?

Nobody cares if Bill Gates has to pay another 1% in taxes (or whatever), other than people who are Bill gates, are like Bill gates, or want and think they can be like Bill Gates.

The very wealthy are very powerful in this country and their hate for the ACA came mostly from the tax increases.  They are about to win on killing them.

 

[mattiasNYC]

I don't disagree.

 

[JohnRoberts]

About how to pay for health care: the ACA included some tax increases to make it work. The Republican plan ends those taxes.
https://www.theatlantic.com/business/archive/2017/03/acha-tax-cut/518889/

The reality is the ACA made the health care system in the US more socialized with tax increases on high incomes, which Republicans are aiming to roll back.  Because outright repealing the coverage of the 20 million or so people would have so much political blowback, it seems they are following a 'starve the beast' strategy to defund it first. And they are limited in what they can do in the reconciliation stage. 
Good luck - I don't see it happening anytime soon. I wish the Democrats had added a public option to the ACA but I don't think they could get it past the big corporate lobbies. Basically let people buy into medicare as a group plan - in competition with private options. Instead of the whole health exchange stuff that didn't work.

"Reconciliation" is an important point that seems to be missing (or too complex) for the public discussion of the ACA repeal and replace effort.  For those who were following this closely at the time, after the democrats lost their supermajority in the senate in 2010, they used reconciliation to finally pass the house version of the ACA in the senate.

Reconciliation is a legislative process of the United States Senate intended to allow consideration of a budget bill with debate limited to twenty hours under Senate rules.

Since the republicans have only a slender majority in the senate 52-48, they are using reconciliation rules for the first phase of repealing the budget (government cost) aspects of the ACA while avoiding democratic filibuster that would take 60 votes to override..

Another phase, a lot of the ACA regulations were soft and only provided a legislative skeleton that administration regulators then fleshed out...  Now new administration regulators can unflesh the regulations they don't want.

I suspect a final phase of the ACA replace may require 60 votes (i.e. buy in from democrats). Approaching this in stages  may look messy or chaotic, it is actually the result of their years of thoughtful analysis.  Unfortunately many republican legislators either don't understand or choose to not be on the same page.

In politics it is far easier to throw stones and criticize a proposal than offer actual solutions, so some (a lot) of this is just posturing to appear to look good to sundry voter bases.

I have been saying for a while that this will not be quick, or surgical... but the multiple phase approach seems sensible...(IMO). Since the media is not good at communicating more than one sentence concepts, I expect a lot of public confusion surrounding this. (It took me a while to figure out what was going on amidst all the sturm und drang. )

JR

 

[fazer]

I'm sure one of you already said this somewhere but countries that have a working healthcare system have arbitration rather than lawyer ambulance chasers.  I saw a documentary awhile back on France and Scandinavia and doctors made like 65k and didn't have the risk of lawsuits or insurance cost and student debt but it also means higher taxes to cover cost.